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H2 receptor antagonists also affect B12 absorption, but less than PPIs

Beyond-use window: reconstituted solution has a limited stable life (commonly a few weeks refrigerated)

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Strong evidence, from decades of treating individuals with inborn errors of B 12 metabolism, supports the safety of parenteral, lifelong, even high dose hydroxocobalamin, sometimes even at very high doses

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Covid-19 vaccinations are no exception, and some people have reported feeling flulike symptoms for several days after receiving the shot